Epidemiologic, Clinical and Mycological Profile of Onychomycosis in the Hospital Setting in Benin

Introduction: Onychomycosis accounts for 50% of nail disorders and remains one of the most frequent reasons for consultation in dermatology. Several factors favour the development of onychomycosis, such as age, morphological abnormalities of the nails, immunodeficiency and certain underlying pathologies. The aim was to study the epidemiological and diagnostic profile of onychomycosis in patients treated in the dermatology and venerology department of the Benin referral hospital. Patients and Methods: This was a retrospective study conducted from 2003 to 2022, covering patients treated for onychomycosis in the Dermatology-Venerology University Clinic at the National University Hospital Center Hubert Koutoukou Maga (NUHC-HKM) in Cotonou. Results: During the study period, 389 new patients were seen for onychopathy, 301 of whom had a clinical suspicion of onychomycosis. Of these, 128 were confirmed by mycological examination, giving a hospital frequency of onychomycosis of 32.90% compared with onychopathy. The mean age was 44.93 ± 12.50 years; the patients were predominantly female, with a sex ratio (M/F) of 0.41. Aesthetic complaints (76.47%) were the most frequent reason for consultation, and the nail of the hand was the most common lesion location. Melanonychia was the most frequent morphological anomaly, and distolateral subungual onychomycosis was the most frequent clinical form. Yeasts (86.92%) were the most isolated group of fungi, followed, respectively, by moulds (08.44%) and dermatophytes (04.64%). Candida albicans (21.52%) was the most common species. Conclusion: Onychomycosis is relatively uncommon in hospitals in Benin. This is underestimated because most patients with a clinical suspicion of onychomycosis do not undergo a mycological examination before being put on antifungal treatment.